The relationship between wasting and stunting in young children: A systematic review
Open accessAbstract
In 2014, the Emergency Nutrition Network published a report on the relationship between wasting and stunting. We aim to review evidence generated since that review to better understand the implications for improving child nutrition, health and survival. We conducted a systematic review following PRISMA guidelines, registered with PROSPERO. We identified search terms that describe wasting and stunting and the relationship between the two. We included studies related to children under five from low‐ and middle‐income countries that assessed both ponderal growth/wasting and linear growth/stunting and the association between the two. We included 45 studies. The review found the peak incidence of both wasting and stunting is between birth and 3 months. There is a strong association between the two conditions whereby episodes of wasting contribute to stunting and, to a lesser extent, stunting leads to wasting. Children with multiple anthropometric deficits, including concurrent stunting and wasting, have the highest risk of near‐term mortality when compared with children with any one deficit alone. Furthermore, evidence suggests that the use of mid‐upper‐arm circumference combined with weight‐for‐age Z score might effectively identify children at most risk of near‐term mortality. Wasting and stunting, driven by common factors, frequently occur in the same child, either simultaneously or at different moments through their life course. Evidence of a process of accumulation of nutritional deficits and increased risk of mortality over a child's life demonstrates the pressing need for integrated policy, financing and programmatic approaches to the prevention and treatment of child malnutrition.
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Some evidence suggests that stunted children, in addition to muscle and fat loss and hormonal imbalances, suffer from deficits in the form of small organ sizes.
“Some evidence suggests that stunted children, in addition to muscle and fat loss and hormonal imbalances, suffer from deficits in the form of small organ sizes [78].”
From Intestinal Parasitic Infection and Nutritional Status in Children under Five Years Old: A Systematic Review (2022) · cites this paper as [78]
A systematic review by Thurstan et al. (2022) showed the relationship between wasting and stunting; wasted children were most likely to also be stunted.
“A systematic review by Thurstan et al. (2022) showed the relationship between wasting and stunting. Wasted children were most likely to also be stunted.”
From Intestinal Parasitic Infection and Nutritional Status in Children under Five Years Old: A Systematic Review (2022) · cites this paper as [78]
Overcrowding in the home with many family members is a factor for parasitic infection, as it leads to intra-family transmission from close contacts.
“Overcrowding in the home with many family members is also a factor, as it leads to intra-family transmission from close contacts, such as when feeding and bathing infants [78,80].”
From Intestinal Parasitic Infection and Nutritional Status in Children under Five Years Old: A Systematic Review (2022) · cites this paper as [78]
The Results section on interconnected physiological processes discusses infection as a cause and consequence of undernutrition, but does not address how infections spread within households. Searches for overcrowding, household size, parasitic infection, close-contact transmission, and infant feeding or bathing found no passage supporting the attributed claim. Page numbers were not provided in our copy. (LLM, conf=0.76)
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Fauziah, N., Aviani, J. K., Agrianfanny, Y. N., & Fatimah, S. N. (2022) · Tropical Medicine and Infectious Disease · doi:10.3390/tropicalmed7110371 · Cited by 122 · see citing works
“Some evidence suggests that stunted children, in addition to muscle and fat loss and hormonal imbalances, suffer from deficits in the form of small organ sizes [78].”
Background
- Authors
- Thurstans, S., Sessions, N., Dolan, C., Sadler, K., Cichon, B., Isanaka, S., Roberfroid, D., Stobaugh, H., Webb, P., & Khara, T.
- Affiliations
- London School of Hygiene & Tropical Medicine (GB)
- Emergency Nutrition Network (ENN) (GB)
- Nutrition for Development UK
- Action Contre la Faim (FR)
- Harvard University (US)
- University of Namur (BE)
- Tufts University (US)
- Corresponding author
- Thurstans, Susan
- ORCID
- Venue
- Maternal & Child Nutrition
- Publisher
- Wiley
- Published
- 2021-09-05
- Volume
- 18
- Issue
- 1
- Pages
- e13246-e13246
- ISSN
- 1740-8695 (ISSN-L)
- 1740-8709
- PMC
- PMC8710094
- OpenAlex
- W3197463108
- Cited by
- 156
- References
- 64
- Citations by year
- 2026: 26 · 2025: 30 · 2024: 43 · 2023: 39 · 2022: 18
- FWCI
- 3.33
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Maternal and Child Nutrition (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Repository of the University of Namur (submittedVersion, other-oa)
- Funders
- Irish Aid (HQPU/2020/ENN)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Public Health and Nutrition
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Keywords
- wasting, stunting, child malnutrition, children under five, mid-upper arm circumference, weight-for-age z-score, linear growth, low- and middle-income countries
- MeSH terms
- Anthropometry, Body Weight, Child, Child, Preschool, Growth Disorders, Humans, Infant, Nutritional Status, Child Nutrition Disorders, Wasting Syndrome
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